Industry Notes:
MEDPAC RECOMMENDS HHA RATE FREEZE FOR 2007
Published on Thu Feb 02, 2006
Freeze unwarranted, industry argues.
Home health agencies might want to get used to the leaner budgets they're currently on under the 2006 rate freeze.
As expected, the Medicare Payment Advisory Commission has recommended another HHA rate freeze in 2007, according to its March 1 report to Congress. The influential advisory body gives a number of justifications for the freeze, including a projected HHA Medicare profit margin of 14.7 percent in 2006.
The number of agencies and home health users has increased in recent years, MedPAC notes in the report. "Considering current margins, increased spending and volume, stable access and quality, and good access to capital, these providers can accommodate next year's cost increases without an increase in base payments," MedPAC says about post-acute providers in a press release.
A rate freeze would come on top of negative inflation updates for HHAs in each of the last five years, the American Association for Homecare notes in a release. "The freeze is unwarranted, unjust and unsound," AAH's Sue Mairena says.
"If Congress approves MedPAC's recommendation, we will call on them to explain to millions of home care patients why Congress has cut this important benefit four years in a row," Carolyn Markey, CEO of the Visiting Nurse Associations of America, says in a release. • Professional Home Care Inc.'s victory on physical therapy salary costs has been short-lived. As expected, the Health and Human Services Administrator has reversed a Provider Reimbursement Review Board decision that sided with the Oklahoma-based HHA on PT salary limits (see Eli's HCW, Vol. XV). Professional is "seriously considering an appeal" in federal court, reports the HHA's attorney, John Jan-sak with Harriman & Jansak in Towson, MD.
About $75,000 is at stake in the PT salary portion of the case, Jansak confirms to Eli. Professional has about a month to decide whether to appeal.
Agencies have routinely won federal district and appeals court cases on this topic, but HHS continues to reverse PRRB decisions on the PT salary guideline issue. That forces HHAs to resort to a federal court appeal to secure their reimbursement.
• Providers may soon find out whether the Deficit Reduction Act is enforceable. Mobile, AL elder law attorney Jim Zeigler filed the first lawsuit disputing the DRA Feb. 13. "My legal point is that the House passed one version, the Senate passed another version and the president signed the Senate version. That violates the Constitution," Zeigler says in a release.
A typo put the rental period for items in the existing home medical equipment capped category at 36 months instead of the 13 months agreed to by the House and Senate. No date for a hearing has been set for Zeigler's lawsuit. • The National Quality Forum will soon be voting on [...]
